Some medical experts who advised state health officials on the development of the regulations suggest that political concerns, not safety problems, were behind the crackdown and are disappointed some of their key recommendations were not followed. Most notably, the regulations adopted by the Board of Health require existing clinics to meet the same strict building standards as new hospital construction. Critics say those guidelines will put most of Virginia's clinics out of business.

Legislation passed last winter by the General Assembly requires that all clinics performing five or more first-trimester abortions per month be regulated like hospitals. The legislation called for emergency regulations to take effect by Dec. 31 and remain in place for a year while permanent regulations are developed.

Supporters of the regulations say the goal is to protect women's health.

Opponents claim the regulations are intended to reduce access to abortions.

A McDonnell spokesman said the Republican governor continues to review the regulations.

"That being said, he has consistently expressed his pro-life position when it comes to issues of abortion," spokesman Jeff Caldwell said.

Dr. James E. Ferguson II, chairman of the Department of Obstetrics and Gynecology at the University of Virginia, is among a half-dozen medical educators chosen by state Health Commissioner Karen Remley to provide guidance in drafting the regulations.

Ferguson said the document adopted by the board in September went well beyond what the advisory panel recommended, and he has told Remley he doesn't want his name associated with the regulations as they are now written.

"I don't know where they got changed, but ultimately they were different, more stringent and more restrictive - and several of them, at least, unnecessary," Ferguson said.

Caroline Gibson, a spokeswoman for Attorney General Kenneth Cuccinelli, said the office advised the board that the strict building standards - which cover things like hallway widths and covered entrances - are mandated by state law.

Dr. Jerome F. Strauss III, dean of Virginia Commonwealth University's School of Medicine, said the advisory panel initially was told that existing clinics could be "grandfathered in" and would not be held to standards that were not in place when they opened. So he was surprised to later learn that was not the case.

"There were clearly changes made, and if they were made by individuals with medical qualifications I guess there could be a discussion, but it's not clear to me that that was the case," Strauss said.

The advisory panel also wanted to limit the regulations to clinics performing surgical abortions, exempting medical terminations of pregnancy, Strauss said. But again, the attorney general's office advised the board that state law makes no distinction between medical and surgical abortions so the board can't either, Gibson said.

Joseph Hilbert, the state Health Department's director of governmental and regulatory affairs, declined to comment directly on the panel members' concerns.

"Certainly we very much value and appreciate the assistance they provided us and their willingness to provide their time and expertise," he said.

Ferguson credits Remley with making "a good faith effort" to give medical professionals a voice in drafting the regulations, but he believes the health department ultimately got too hung up on mirroring South Carolina's clinic regulations, which courts have declared constitutional. He said the advisory panel also borrowed from guidelines from the American Congress of Gynecologists and Obstetricians and other sources, but the final product closely tracks the South Carolina regulations.

According to Ferguson, the South Carolina clinic regulations are inappropriate in some respects for Virginia because they cover first- and second-trimester abortions. Second-trimester abortions in Virginia must be done in hospitals.

"There were more than a few things I felt were unnecessary that were just stuck in there because South Carolina had it in there," Ferguson said.
Ferguson also questioned the need for the strict regulations.

"I asked, `Do we have evidence there are problems in this area? Are women getting sick and are women dying?' And the answer was no," Ferguson said.

Not all medical professionals who contributed to the process were dissatisfied. Dr. John W. Seeds, a senior associate dean at VCU, said the regulations "were written carefully to be compliant with constitutional safeguards."

He also said clinic structure requirements were "not within the expertise of the advisory group" and acknowledged that the board had no obligation to follow the panel's recommendations.